CSANews 81

Winter 2011 » Issue 81

Of course, the best kind of policy is one that covers you if you are taking a drug. The insurer will want you to be stable for a period of time (90 days in the case of Medipac), and your drug dosage must not have changed during this period; otherwise, it is considered unstable. If the dosage has changed in this 90-day period, beware – claims will not be covered. If this happens with Medipac, we can usually revise your policy to full coverage if you call us. Naturally, there is often an additional charge, but this is nothing compared to a denied claim. But remember those details which we talked about in other policies. When you get deeper into some policy wordings, you may find that the “advertised” stability period of, say 90 days, has restrictions.

There are several policies that have different stability periods for different diseases. A common policy position is to have a 60- or 90-day pre-ex period, but a 180-day pre-ex built into the policy for (guess what) heart, lung and often internal issues. In other words, longer pre-ex periods apply for the things that most people have. I have seen pre-ex periods of five years in a policy. I do not know of anyone who could guarantee that their drug dosage or type has not changed in five years; even knowing for sure for one year is tough enough. The insurance company will find out, though, and that is
not the time for you to find out, too. I urge extreme caution with these long pre-ex periods; 90 days is long enough!